Outpatient Ductal Steroid Irrigations as an Adjuvant Treatment to Sialendoscopy in Recurrent Inflammatory Obstructive Sialadenitis

Abstract

The aim of this study is to retrospectively investigate the effectiveness of outpatient ductal steroid irrigations (DSIs) as an adjuvant treatment in recurrent inflammatory obstructive sialadenitis (RIOS). A retrospective chart review of prospectively recruited RIOS patients was randomly assigned to group A (i.e., interventional sialendoscopy) or group B (i.e., interventional sialendoscopy with outpatient DSIs). The statistical analysis detected any postoperative difference between groups in terms of the number and severity (attested by 0–10 VAS pain) of episodes of swelling. Interventional sialendoscopy and DSIs were effective and well tolerated in all 122 patients, and a significantly reduced number of salivary gland swelling episodes (p-value = 0.01) was documented in group B compared to group A at any follow-up assessment. When the specific aetiology was considered, repeated DSIs were more effective than interventional sialendoscopy alone in patients with type 1 or 3 stenoses and in those without mucous plugs. Our results confirm the safety and effectiveness of interventional sialendoscopy (both as a single-modality and a multimodal approach) in a large series of adult patients with RIOS at short-, medium-, and long-term analyses. The superiority of a combined therapeutic protocol, with a positive effect still detectable 12 months after the end of the treatment, was attested as well.

Keywords

• sialendoscopy
• sialadenitis
• salivary gland
• infection